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Factor analyses of 75 facet scales from 2 major Big Five inventories, in the Eugene-Springfield community sample (N=481), produced a 2-factor solution for the 15 facets in each domain. These findings indicate the existence of 2 distinct (but correlated) aspects within each of the Big Five, representing an intermediate level of personality structure between facets and domains. The authors characterized these factors in detail at the item level by correlating factor scores with the International Personality Item Pool (L. R. Goldberg, 1999). These correlations allowed the construction of a 100-item measure of the 10 factors (the Big Five Aspect Scales [BFAS]), which was validated in a 2nd sample (N=480). Finally, the authors examined the correlations of the 10 factors with scores derived from 10 genetic factors that a previous study identified underlying the shared variance among the Revised NEO Personality Inventory facets (K. L. Jang et al., 2002). The correspondence was strong enough to suggest that the 10 aspects of the Big Five may have distinct biological substrates.

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Entropy, a concept derived from thermodynamics and information theory, describes the amount of uncertainty and disorder within a system. Self-organizing systems engage in a continual dialogue with the environment and must adapt themselves to changing circumstances to keep internal entropy at a manageable level. We propose the entropy model of uncertainty (EMU), an integrative theoretical framework that applies the idea of entropy to the human information system to understand uncertainty-related anxiety. Four major tenets of EMU are proposed: (a) Uncertainty poses a critical adaptive challenge for any organism, so individuals are motivated to keep it at a manageable level; (b) uncertainty emerges as a function of the conflict between competing perceptual and behavioral affordances; (c) adopting clear goals and belief structures helps to constrain the experience of uncertainty by reducing the spread of competing affordances; and (d) uncertainty is experienced subjectively as anxiety and is associated with activity in the anterior cingulate cortex and with heightened noradrenaline release. By placing the discussion of uncertainty management, a fundamental biological necessity, within the framework of information theory and self-organizing systems, our model helps to situate key psychological processes within a broader physical, conceptual, and evolutionary context.

Higher levels of depressive affect in ESRD patients treated with HD are associated with increased mortality. The effects of depression on patient survival are of the same order of magnitude as medical risk factors. Our findings using both controls for factors possibly confounded with depressive affect in patients with ESRD and time-varying covariate analyses may explain the inconsistent results of previous studies of depression and mortality in ESRD patients. Time-varying analyses in longitudinal studies may add power to defining and sensitivity to establishing the association of psychosocial factors and survival in ESRD patients. The mechanism underlying the relationship of depression and survival and the effect of interventions to improve depression in HD outpatients and general medical inpatients should be studied.

The prevalence, severity, and clinical significance of physical and emotional symptoms in patients who are on maintenance hemodialysis remain incompletely characterized. This study sought to assess symptoms and their relationship to quality of life and depression. The recently developed Dialysis Symptom Index was used to assess the presence and the severity of 30 symptoms. The Illness Effects Questionnaire and Beck Depression Inventory were used to evaluate quality of life and depression, respectively. Correlations among symptom burden, symptom severity, quality of life, and depression were assessed using Spearman correlation coefficient. A total of 162 patients from three dialysis units were enrolled. Mean age was 62 y, 48% were black, 62% were men, and 48% had diabetes. The median number of symptoms was 9.0 (interquartile range 6 to 13). Dry skin, fatigue, itching, and bone/joint pain each were reported by >50% of patients. Seven additional symptoms were reported by >33% of patients. Sixteen individual symptoms were described as being more than "somewhat bothersome." Overall symptom burden and severity each were correlated directly with impaired quality of life and depression. In multivariable analyses adjusting for demographic and clinical variables including depression, associations between symptoms and quality of life remained robust. Physical and emotional symptoms are prevalent, can be severe, and are correlated directly with impaired quality of life and depression in maintenance hemodialysis patients. Incorporating a standard assessment of symptoms into the care provided to maintenance hemodialysis patients may provide a means to improve quality of life in this patient population.